理气和胃制酸法治疗慢性糜烂性胃炎的临床研究

发布时间：2018-08-16 17:53

【摘要】：目的：本课题针对慢性糜烂性胃炎(CEG),通过中医辨证论治,结合当地病患特点及昆山中医院治疗CEG的临床经验,对应用中药煎剂联合PPI(奥美拉唑)制酸护胃治疗,与单用西药治疗在临床疗效、内镜及病理的改变等进行对比研究,以验证中医药治疗的有效性。方法：选取昆山市中医院就诊,并且符合慢性糜烂性胃炎诊断标准的患者80例,用随机对照的方法分为治疗组和对照组,每组各40例,治疗组给予中药煎剂联合奥美拉唑治疗,中药煎剂为导师经验方(苏梗10g,炒白芍20g,浙贝母10g,枳壳10g,乌贼骨15g,仙鹤草30g,煅瓦楞子30g),临证加减；对照组给予口服奥美拉唑肠溶胶囊及瑞巴派特。一个疗程后进行评定,疗程均为六周,结果比较两组治疗前后在内镜及病理疗效、中医证候疗效、临床综合疗效的改善情况。结果：在临床综合疗效方面,治疗组总有效率为97.22%,对照组为87.5%,两组间比较有差异(P0.05),证明治疗组优于对照组。在改善中医证候疗效方面,对胃脘痛、胃胀、嗳气、泛酸的改善,差异有统计学意义(P0.05)；在中医症状积分方面,两组治疗后组间比较提示均有差异,其中治疗组差异显著,即P0.01；内镜下胃粘膜改变的疗效相比,组间比较有统计学意义(P0.05),治疗组总有效率97.22%,优于对照组的87.5%。对治疗后胃粘膜病理改变的疗效比较,组间比较有统计学意义(P0.05),治疗组总有效率94.44%,优于对照组的87.5%。结论：以中药煎剂联合西药制酸护胃治疗,对于慢性糜烂性胃炎有显著疗效,在改善临床症状,内镜、病理的改变方面效果均理想。
[Abstract]:Objective: to treat chronic erosive gastritis (CEG),) with traditional Chinese medicine (TCM) differentiation of symptoms and signs, combined with the characteristics of local patients and the clinical experience of Kunshan traditional Chinese Medicine Hospital in the treatment of CEG, and to treat CEG with traditional Chinese medicine decoction combined with Omeprazole (Omeprazole). To verify the effectiveness of traditional Chinese medicine (TCM), the clinical efficacy, endoscopy and pathological changes were compared with that of western medicine alone. Methods: 80 patients with chronic erosive gastritis were selected from Kunshan traditional Chinese Medicine Hospital. They were randomly divided into treatment group and control group with 40 cases in each group. The treatment group was treated with traditional Chinese medicine decoction combined with omeprazole. Traditional Chinese medicine decoction was used as tutor's prescription (Su pedicel 10g, fried white peony 20g, Zhejiang Fritillaria 10g, Fructus Aurantii 10g, squid bone 15g, Herba Sinensis 30g, calcined corrugated seed 30g), and the control group was given omeprazole enteric dissolving capsule and repapet. One course of treatment was evaluated, and the course of treatment was six weeks. Results the improvement of endoscopic and pathological effects, TCM syndromes and clinical comprehensive efficacy were compared between the two groups before and after treatment. Results: the total effective rate was 97.22 in the treatment group and 87.5 in the control group. The difference between the two groups (P0.05) proved that the treatment group was superior to the control group. In improving the curative effect of TCM syndromes, the improvement of stomachache, stomach distention, belching and pantothenic acid had statistical significance (P0.05); in the aspect of TCM symptom integral, the comparison between the two groups showed that there were differences after treatment, among which the difference was significant in the treatment group. The curative effect of endoscopic gastric mucosal changes was statistically significant (P0.05). The total effective rate of the treatment group was 97.22, which was better than that of the control group (87.5%). The curative effect of gastric mucosal pathological changes after treatment was statistically significant (P0.05). The total effective rate of the treatment group was 94.444.It was better than that of the control group (87.5%). Conclusion: it is effective to treat chronic erosive gastritis with traditional Chinese medicine decoction combined with western medicine. It is ideal in improving clinical symptoms endoscopy and pathological changes.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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